Why does M. abscessus need different antibiotics than MAC?
Patient's Query
Hello doctor,
I am 29 years old and after testing for several months I was recently diagnosed with a mycobacterial lung infection. After several months of tests, I was told I had a lung infection with mycobacteria. My pulmonologist is currently trying to determine if it is MAC or Mycobacterium abscessus, and I understand that this difference is important for treatment. Can you explain why Mycobacterium abscessus requires a different antibiotic than MAC, especially someone of my age? I've been waiting for the culture results for almost 6 weeks now and in the meantime my symptoms, especially cough and fatigue, have only been getting worse. I am confused as to why it takes so long to confirm the precise strain and if there are hazards or factors to consider before starting therapy while waiting for the final culture results. I am worried that if I am diagnosed late, I will not get the treatment I need.Kindly help.
Hi,
Welcome to icliniq.com.
Your health care team is trying to tell the difference between Mycobacterium avium complex (MAC) and Mycobacterium abscessus. These are very different infections, and each has a treatment plan. MAC grows slowly and is treated with oral antibiotics for many months.
Mycobacterium abscessus, however, is resistant to standard therapies and often requires aggressive intravenous therapy. With appropriate treatment, the response may be less predictable. If treatment starts before the exact infection is known, it might not work and could make the infection worse.
That's why it's important to find out which organism is the culprit. The main reason you're experiencing the delay is that these bacteria grow slowly in laboratory cultures. More tests will be needed once they start to grow to find out exactly what kind they are and which antibiotics will work best. It takes time, but it is important to get the right treatment.
For patients who are stable, doctors will usually wait for the results to come back before starting treatment, since the wrong antibiotic may reduce the effectiveness of any future treatment. If symptoms are worsening or the disease seems to be progressing, your pulmonologist may start you on a temporary treatment and then adjust it once the results are in.
Since your cough and fatigue are worsening, I would suggest talking to your pulmonologist about these changes.
Thank you.
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